Li Chiu Kong Family Sleep assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Sleep. 2021 Aug 13;44(8). doi: 10.1093/sleep/zsab053.
We aimed to investigate the prospective associations of sleep phenotypes with severe intentional self-harm (ISH) in middle-aged and older adults.
A total of 499,159 participants (mean age: 56.55 ± 8.09 years; female: 54.4%) were recruited from the UK Biobank between 2006 and 2010 with follow-up until February 2016 in this population-based prospective study. Severe ISH was based on hospital inpatient records or a death cause of ICD-10 codes X60-X84. Patients with hospitalized diagnosis of severe ISH before the initial assessment were excluded. Sleep phenotypes, including sleep duration, chronotype, insomnia, sleepiness, and napping, were assessed at the initial assessments. Cox regression analysis was used to estimate temporal associations between sleep phenotypes and future risk of severe ISH.
During a follow-up period of 7.04 years (SD: 0.88), 1,219 participants experienced the first hospitalization or death related to severe ISH. After adjusting for demographics, substance use, medical diseases, mental disorders, and other sleep phenotypes, short sleep duration (HR: 1.50, 95% CI: 1.23-1.83, p < .001), long sleep duration (HR: 1.56, 95% CI: 1.15-2.12, p = .004), and insomnia (usually: HR: 1.57, 95% CI: 1.31-1.89, p < .001) were significantly associated with severe ISH. Sensitivity analyses excluding participants with mental disorders preceding severe ISH yielded similar results.
The current study provides the empirical evidence of the independent prediction of sleep phenotypes, mainly insomnia, short- and long-sleep duration, for the future risk of severe ISH among middle-aged and older adults.
我们旨在探讨睡眠表型与中老年人群中严重蓄意自伤（ISH）的前瞻性关联。
本研究采用基于人群的前瞻性研究设计，于 2006 年至 2010 年间从英国生物库（UK Biobank）招募了 499159 名参与者（平均年龄：56.55±8.09 岁；女性：54.4%），随访至 2016 年 2 月。严重 ISH 基于住院患者记录或 ICD-10 编码 X60-X84 的死因。排除在初始评估前因严重 ISH 住院诊断的患者。在初始评估时评估睡眠表型，包括睡眠时间、睡眠时型、失眠、嗜睡和小睡。使用 Cox 回归分析来估计睡眠表型与未来严重 ISH 风险之间的时间关联。
在 7.04 年的随访期间（标准差：0.88 年），有 1219 名参与者经历了首次与严重 ISH 相关的住院或死亡。在校正人口统计学、物质使用、医疗疾病、精神障碍和其他睡眠表型后，短睡眠时间（HR：1.50，95%CI：1.23-1.83，p<.001）、长睡眠时间（HR：1.56，95%CI：1.15-2.12，p=0.004）和失眠（通常：HR：1.57，95%CI：1.31-1.89，p<.001）与严重 ISH 显著相关。排除严重 ISH 之前存在精神障碍的参与者进行敏感性分析，得出了相似的结果。
本研究提供了实证证据，表明睡眠表型（主要是失眠、短睡眠时间和长睡眠时间）可独立预测中老年人群严重 ISH 的未来风险。
